Kathy T. Vo

TL;DR: In 2014, the first illicit pills containing fentanyl, fentanyl analogs, and other novel synthetic opioids such as U-47700 were detected as mentioned in this paper, and since then, fentanyl has caused deaths in every state and fentanyl and its analogs have completely infiltrated the North American heroin supply.

TL;DR: Synthetic opioids are an increasingly major public health threat requiring vigilance from multiple fields including law enforcement, government agencies, clinical chemists, pharmacists, and physicians, to name a few, in order to stem its tide.

TL;DR: The identification of 8 patients who experienced adverse effects associated with the ingestion of counterfeit alprazolam tablets found to contain fentanyl and, in some cases, etizolam resulted in a coordinated response that included state and local public health departments, a toxicology laboratory, and media outlets, and resulted in an investigation by local law enforcement agencies.

TL;DR: In general, pediatric patients had more severe symptoms and longer hospital length of stay, and, uniquely, a majority presented with leukocytosis and elevated lactic acid levels.

TL;DR: It is suggested that the patient, who demonstrated an interest and use of synthetic agents, likely ingested a BZD derivative, and should be considered in patients with drug abuse and an unknown source of a positive BzD screen on urine immunoassay.